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| Zika outbreak: What you need to know | Zika outbreak: What you need to know |
| (2 months later) | |
| The World Health Organization has declared the Zika virus a global public health emergency. | The World Health Organization has declared the Zika virus a global public health emergency. |
| The infection is suspected of leading to thousands of babies being born with underdeveloped brains. | The infection is suspected of leading to thousands of babies being born with underdeveloped brains. |
| Some areas have declared a state of emergency, doctors have described it as "a pandemic in progress" and some are even advising women in affected countries to delay getting pregnant. | Some areas have declared a state of emergency, doctors have described it as "a pandemic in progress" and some are even advising women in affected countries to delay getting pregnant. |
| But there is much we do not know in this emerging infection. | But there is much we do not know in this emerging infection. |
| What are the symptoms? | What are the symptoms? |
| Deaths are rare and only one-in-five people infected is thought to develop symptoms. | Deaths are rare and only one-in-five people infected is thought to develop symptoms. |
| These include: | These include: |
| A rare nervous system disorder, Guillain-Barre syndrome, that can cause temporary paralysis has been linked to the infection. | A rare nervous system disorder, Guillain-Barre syndrome, that can cause temporary paralysis has been linked to the infection. |
| There is no vaccine or drug treatment so patients are advised to rest and drink plenty of fluids. | There is no vaccine or drug treatment so patients are advised to rest and drink plenty of fluids. |
| But the biggest concern is the impact it could have on babies developing in the womb and the surge in microcephaly. | But the biggest concern is the impact it could have on babies developing in the womb and the surge in microcephaly. |
| Zika virus: Special report | Zika virus: Special report |
| What is microcephaly? | What is microcephaly? |
| It is when a baby is born with an abnormally small head, as their brain has not developed properly. | It is when a baby is born with an abnormally small head, as their brain has not developed properly. |
| The severity varies, but it can be deadly if the brain is so underdeveloped that it cannot regulate the functions vital to life. | The severity varies, but it can be deadly if the brain is so underdeveloped that it cannot regulate the functions vital to life. |
| Children that do survive face intellectual disability and development delays. | Children that do survive face intellectual disability and development delays. |
| It can be caused by infections such as rubella, substance abuse during pregnancy or genetic abnormalities. | It can be caused by infections such as rubella, substance abuse during pregnancy or genetic abnormalities. |
| Case study: 'It's not the end of the world' | Case study: 'It's not the end of the world' |
| Brazil had fewer than 150 cases of microcephaly in the whole of 2014. | Brazil had fewer than 150 cases of microcephaly in the whole of 2014. |
| But more than 4,700 cases have been reported since 22 October 2015, with 404 confirmed and 3,670 still being investigated. | But more than 4,700 cases have been reported since 22 October 2015, with 404 confirmed and 3,670 still being investigated. |
| The link with Zika has not been confirmed, but the WHO says it is "strongly suspected". | The link with Zika has not been confirmed, but the WHO says it is "strongly suspected". |
| Some babies who died had the virus in their brain and it has been detected in placenta and amniotic fluid too. | Some babies who died had the virus in their brain and it has been detected in placenta and amniotic fluid too. |
| Why hasn't microcephaly been seen in other countries? | Why hasn't microcephaly been seen in other countries? |
| Cases of microcephaly have been centred in north-east Brazil, but the outbreak has affected more than 20 countries. | Cases of microcephaly have been centred in north-east Brazil, but the outbreak has affected more than 20 countries. |
| So where are the other cases of microcephaly? | So where are the other cases of microcephaly? |
| The outbreak started in Brazil before spreading elsewhere, and the World Health Organization says there will be a lag of several months to know if pregnant women in these newly affected countries are affected too. | The outbreak started in Brazil before spreading elsewhere, and the World Health Organization says there will be a lag of several months to know if pregnant women in these newly affected countries are affected too. |
| There have been suggestions that Zika led to a rise in birth defects after the 2013 outbreak in French Polynesia. | There have been suggestions that Zika led to a rise in birth defects after the 2013 outbreak in French Polynesia. |
| The race to understand link to microcephaly | The race to understand link to microcephaly |
| Is it safe to try for a baby? | Is it safe to try for a baby? |
| The link to microcephaly is not certain, but some governments have advised women to delay getting pregnant until more is known. | The link to microcephaly is not certain, but some governments have advised women to delay getting pregnant until more is known. |
| Experts now believe the virus is linked to a broader set of complications in pregnancy, including miscarriage, stillbirth, premature birth and eye problems. | Experts now believe the virus is linked to a broader set of complications in pregnancy, including miscarriage, stillbirth, premature birth and eye problems. |
| The US Centres for Disease Control says Zika lingers in the blood for about a week and can be spread by sexual intercourse. | The US Centres for Disease Control says Zika lingers in the blood for about a week and can be spread by sexual intercourse. |
| "The virus will not cause infections in a baby that is conceived after the virus is cleared from the blood," it says. | "The virus will not cause infections in a baby that is conceived after the virus is cleared from the blood," it says. |
| "There is currently no evidence that Zika-virus infection poses a risk of birth defects in future pregnancies." | "There is currently no evidence that Zika-virus infection poses a risk of birth defects in future pregnancies." |
| The WHO advises couples practice safer sex or abstain for at least eight weeks if they are returning from Zika-affected areas. If the man in the couple planning a pregnancy develops Zika symptoms, then this period of abstinence or safe sex should be extended to six months. | The WHO advises couples practice safer sex or abstain for at least eight weeks if they are returning from Zika-affected areas. If the man in the couple planning a pregnancy develops Zika symptoms, then this period of abstinence or safe sex should be extended to six months. |
| Why is it a public health emergency? | Why is it a public health emergency? |
| The World Health Organization is worried that Zika is spreading far and fast, with devastating consequences. | The World Health Organization is worried that Zika is spreading far and fast, with devastating consequences. |
| Declaring Zika as a "public health emergency of international concern" singles the disease out as a serious global threat. It puts it in the same category of importance as Ebola. | Declaring Zika as a "public health emergency of international concern" singles the disease out as a serious global threat. It puts it in the same category of importance as Ebola. |
| Unlike Ebola, where the focus was on boots on the ground, with Zika the attention will be on understanding the link with microcephaly. | Unlike Ebola, where the focus was on boots on the ground, with Zika the attention will be on understanding the link with microcephaly. |
| The WHO will coordinate countries' health agencies to conduct trials to determine the risk. | The WHO will coordinate countries' health agencies to conduct trials to determine the risk. |
| It will also encourage efforts to stop the mosquito that spreads the disease as well as finding a treatment or a vaccine to stop the virus. | It will also encourage efforts to stop the mosquito that spreads the disease as well as finding a treatment or a vaccine to stop the virus. |
| The work will depend on money donated by countries. | The work will depend on money donated by countries. |
| Where did Zika come from? | Where did Zika come from? |
| It was first identified in monkeys in Uganda in 1947. | It was first identified in monkeys in Uganda in 1947. |
| The first human case was detected in Nigeria in 1954 and there have been further outbreaks in Africa, South East Asia and the Pacific Islands. | The first human case was detected in Nigeria in 1954 and there have been further outbreaks in Africa, South East Asia and the Pacific Islands. |
| Most were small and Zika has not previously been considered a major threat to human health. | Most were small and Zika has not previously been considered a major threat to human health. |
| But in May 2015 it was reported in Brazil and has spread rapidly. | But in May 2015 it was reported in Brazil and has spread rapidly. |
| It has since also been reported in: Barbados, Bolivia, Colombia, the Dominican Republic, Ecuador, El Salvador, French Guiana, Guatemala, Guadeloupe, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname and Venezuela. | It has since also been reported in: Barbados, Bolivia, Colombia, the Dominican Republic, Ecuador, El Salvador, French Guiana, Guatemala, Guadeloupe, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname and Venezuela. |
| At the end of July, health officials in Florida confirmed that 14 cases of Zika in an area of downtown Miami were likely to have been contracted from local mosquitoes. | |
| "Its current explosive pandemic re-emergence is, therefore, truly remarkable," the US National Institutes of Health said. | "Its current explosive pandemic re-emergence is, therefore, truly remarkable," the US National Institutes of Health said. |
| How does it spread? | How does it spread? |
| It is spread by Aedes mosquitoes. | It is spread by Aedes mosquitoes. |
| They are found throughout the Americas except for Canada and Chile where it is too cold for them to survive. | They are found throughout the Americas except for Canada and Chile where it is too cold for them to survive. |
| If they drink the blood of an infected person they can then infect subsequent people they bite. | If they drink the blood of an infected person they can then infect subsequent people they bite. |
| It is unclear for how long someone can transmit the virus after being infected. | It is unclear for how long someone can transmit the virus after being infected. |
| They are the same insects that spread dengue and chikungunya virus. | They are the same insects that spread dengue and chikungunya virus. |
| And, unlike the mosquitoes that spread malaria, they are mostly active during the day, so bed nets offer limited protection. | And, unlike the mosquitoes that spread malaria, they are mostly active during the day, so bed nets offer limited protection. |
| The WHO expects Zika to spread throughout the Americas, but other scientists have warned that countries in Asia could face large outbreaks too. | The WHO expects Zika to spread throughout the Americas, but other scientists have warned that countries in Asia could face large outbreaks too. |
| Can it be spread through sex? | Can it be spread through sex? |
| There have been reported cases of sexual transmission with the virus spreading to people who have not visited affected countries. | There have been reported cases of sexual transmission with the virus spreading to people who have not visited affected countries. |
| This seems to be a very rare event, but it means Zika has a limited potential to spread in any country - not just those with the Aedes mosquito. | This seems to be a very rare event, but it means Zika has a limited potential to spread in any country - not just those with the Aedes mosquito. |
| Some countries advise men returning home from affected countries to use condoms if their partner is pregnant or might become pregnant. | Some countries advise men returning home from affected countries to use condoms if their partner is pregnant or might become pregnant. |
| This should be done for 28 days after coming home if you have no symptoms, and for six months if Zika symptoms do develop. | This should be done for 28 days after coming home if you have no symptoms, and for six months if Zika symptoms do develop. |
| Zika virus has also been found in other bodily fluids including saliva and urine, but it is unknown whether the virus can spread through these routes. | Zika virus has also been found in other bodily fluids including saliva and urine, but it is unknown whether the virus can spread through these routes. |
| How long are people infectious? | How long are people infectious? |
| The best evidence so far suggests that people can spread the virus via mosquitoes for a week after being infected. | The best evidence so far suggests that people can spread the virus via mosquitoes for a week after being infected. |
| In semen it may persist for two weeks. | In semen it may persist for two weeks. |
| Countries have advised safe sex and a ban on blood donations for a month after just visiting such countries and for longer if they developed symptoms. | Countries have advised safe sex and a ban on blood donations for a month after just visiting such countries and for longer if they developed symptoms. |
| What can people do? | What can people do? |
| As there is no treatment, the only option is to reduce the risk of being bitten. | As there is no treatment, the only option is to reduce the risk of being bitten. |
| Health officials advise people to: | Health officials advise people to: |
| The mosquitoes lay their eggs in standing water, so people are also being told to empty buckets and flower pots. | The mosquitoes lay their eggs in standing water, so people are also being told to empty buckets and flower pots. |
| The US Centers for Disease Control has advised pregnant women not to travel to affected areas. | The US Centers for Disease Control has advised pregnant women not to travel to affected areas. |
| What is being done? | What is being done? |
| The Brazilian Health Minister, Marcelo Castro, has said a new testing kit is being developed to identify infections quickly. | The Brazilian Health Minister, Marcelo Castro, has said a new testing kit is being developed to identify infections quickly. |
| He also said more money was being put into the development of a vaccine. | He also said more money was being put into the development of a vaccine. |
| Some scientists are also trialling the use of genetically modified sterile mosquitoes that appear to reduce mosquito populations by 90%. | Some scientists are also trialling the use of genetically modified sterile mosquitoes that appear to reduce mosquito populations by 90%. |
| Meanwhile, efforts are under way to kill the mosquitoes with insecticide. | Meanwhile, efforts are under way to kill the mosquitoes with insecticide. |
| Zika vaccine | Zika vaccine |
| US experts from the National Institutes of Health say trials of a Zika vaccine will likely start in September this year. Depending on the results, larger trials could begin at the start of 2017. | US experts from the National Institutes of Health say trials of a Zika vaccine will likely start in September this year. Depending on the results, larger trials could begin at the start of 2017. |
| "The very, very best scenario" would be a vaccine ready for the general public by the beginning of 2018, they say. | "The very, very best scenario" would be a vaccine ready for the general public by the beginning of 2018, they say. |
| Are the Olympic Games under threat? | Are the Olympic Games under threat? |
| Rio de Janeiro is the host city for the 2016 Olympic Games from 5 to 21 August. | Rio de Janeiro is the host city for the 2016 Olympic Games from 5 to 21 August. |
| The Brazilian authorities will be targeting the mosquitoes' breeding grounds in the run-up to the Games. | The Brazilian authorities will be targeting the mosquitoes' breeding grounds in the run-up to the Games. |
| The International Olympic Committee says it is in "close contact" with the Rio organisers and that Olympic venues will be inspected daily in the lead-up to and during this summer's Games. | The International Olympic Committee says it is in "close contact" with the Rio organisers and that Olympic venues will be inspected daily in the lead-up to and during this summer's Games. |
| It will be to ensure puddles of stagnant water, where mosquitoes breed, are removed to minimise the risk of athletes and visitors coming into contact with the insects. | It will be to ensure puddles of stagnant water, where mosquitoes breed, are removed to minimise the risk of athletes and visitors coming into contact with the insects. |
| There is also some hope there will be fewer mosquitoes in August as the month is both cooler and drier. | There is also some hope there will be fewer mosquitoes in August as the month is both cooler and drier. |
| Follow James on Twitter. | Follow James on Twitter. |